Comparative cost analysis of single-level eLLIFp, LLIF with posterior fixation, TLIF, PLIF, PLF, and ALIF.
| Procedure (Single-Level Adjacent Segment Disease/Extension of Construct) | Implant | Implant Charges | Total Implant Charges | OR Charges (Mean OR Time @ $2500/h) | Inpatient Hospital Charges (Mean LOS @ $1335/d) | Total Specialist (Surgeon + Anesthetist @ $19.80/unit) Medicare Charges67 | Cell Saver | Intraoperative Neural Monitoring | Mean Total Costa | Cost Relativity (Using eLLIFp as Index) |
| eLLIFp | Expandable lateral cage with plate screws | $6021; $186 × 2 (2 screws) | $6393 | $5000 (2 h) | $4005 (3 d) | $2817 ($2193 + $614 [31 units]) | N/A | $1500 | $19,715 | 1 |
| LLIF with posterior fixation | Expandable lateral cage; Polyaxial screws; Caps/blockers; Prelordosed rods | $3335; $1232 × 2 (2 screws); $560 × 6 (6 caps); $410 × 2 (2 rods) | $9979 | $7500 (3 h) | $4005 (3 d) | $3656 ($2923 + $733 [37 units]) | N/A | $1500 | $26,640 | 1.4 |
| TLIF | Expandable TLIF cage; Polyaxial screws; Caps/blockers; Prelordosed rods | $3335; $1232 × 2 (2 screws)b; $560 × 6 (6 caps); $410 × 2 (2 rods) | $9979 | $7500 (3 h) | $6675 (5 d) | $3514 ($2663 + $851 [43 units]) | Optional | N/A | $27,668 | 1.4 |
| PLIF | Expandable PLIF cage; Polyaxial screws; Caps/blockers; Prelordosed rods | $2780 × 2 (2 cages); $1232 × 2 (2 screws)b; $560 × 6 (6 caps); $410 × 2 (2 rods) | $12,204 | $7500 (3 h) | $6675 (5 d) | $3514 ($2663 + $851 [43 units]) | $500 | N/A | $30,393 | 1.5 |
| PLF | Polyaxial screws; Caps/blockers; Prelordosed rods | $1232 × 2 (2 screws)b; $560 × 6 (6 caps); $410 × 2 (2 rods) | $6644 | $6250 (2.5 h) | $5340 (4 d) | $3232 ($2499 + $733 [37 units]) | $500 | N/A | $21,966 | 1.1 |
| ALIF | Integrated static cage; Screws | $6021; $186 × 3 (3 screws) | $6579 | $7500 (3 h) | $6675 (5 d) | $2613 ($1880 + $733 [37 units]) plus vascular surgeon: $1186 | $500 | N/A | $25,053 | 1.3 |
Note: All costs given in Australian dollars.
a Total cost does not include charges for bone graft substitutes (which depend on the surgeon’s preference).
bAssumes posterior fixation with 2 new screws above the construct and using the existing screws below with new caps.
ALIF, anterior lumbar interbody fusion; eLLIFp, expandable lateral titanium interbody cages with integrated lateral plate fixation; LLIF, lateral lumbar interbody fusion; LOS, length of stay; N/A, not applicable; OR, operating room; PLF, posterolateral instrumented fusion; PLIF, posterior lumbar interbody fusion; TLIF, transforaminal lumbar interbody fusion.